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1184893497
RACHAEL MARY STACOM
BRONX, NY
NPI
1184893497
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY 304736)
Enumeration Date
2008-02-21
Last Update Date
2008-02-21
Business Address
-- RACHAEL MARY STACOM ANP
1770 GRAND CONCOURSE SUITE 2G
BRONX, NY 10457-5524
Phone number: 718-393-7617
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Mailing Address
-- RACHAEL MARY STACOM ANP
37 E 83RD ST APT 1
NEW YORK, NY 10028-0813
Phone number: 212-744-6731
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